Abstract:
STUDY DESIGN:Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP), a prospectively collected multicenter surgical outcomes database. OBJECTIVE:To determine the effect of preoperative nutritional status, as measured by serum albumin concentration, on outcomes following anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA:Nutritional status has been shown to be an important predictor of postoperative recovery and outcomes. Serum albumin concentration is an established marker of overall nutrition and systemic disease, however, its correlation to outcomes following ACDF is unknown. METHODS:ACDF cases from 2005 to 2010 were identified in the NSQIP and categorized by preoperative serum albumin: normal (≥3.5 g/dL), hypoalbuminemic (<3.5 g/dL), or not measured. Independent demographic and comorbidity variables were assessed, including American Society of Anesthesiologists (ASA) classification. Risk factors for major postoperative complications were identified, including preoperative hypoalbuminemia, and incorporated into a multivariable logistic regression model to determine the strength of preoperative hypoalbuminemia as an adjusted predictor of major postoperative complications. RESULTS:There were 3671 ACDF cases, of which 1382 (37.6%) had preoperative albumin measurements. Patients with albumin measurements were older and more likely to have higher ASA class, hypertension, and diabetes. Hypoalbuminemic patients had higher rates of having any major postoperative complication(s), specifically pulmonary complications, cardiac complications, and reoperation, relative to those with normal albumin (all P<0.01). These patients also had longer lengths of stay (5.0 vs. 1.9 d). With multivariable regression, preoperative hypoalbuminemia was a strong independent predictor of major postoperative complications, with an adjusted odds ratio of 3.37 (P=0.003). CONCLUSIONS:In this analysis of a prospective surgical outcomes database, preoperative serum hypoalbuminemia was an important adjunct predictor of major complications following ACDF. In high-risk patients with multiple medical comorbidities, we recommend that clinicians consider nutritional screening and optimization as part of preoperative risk assessment.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Fu MC,Buerba RA,Grauer JNdoi
10.1097/BSD.0000000000000181subject
Has Abstractpub_date
2016-05-01 00:00:00pages
167-72issue
4eissn
2380-0186issn
2380-0194journal_volume
29pub_type
杂志文章abstract::Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a signific...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000442
更新日期:2017-04-01 00:00:00
abstract::Randomized clinical trials often represent the highest level of clinical evidence available to evaluate the efficacy of an intervention in clinical medicine. Although the process of randomization serves to maximize internal validity, the external validity, or generalizability, of such studies depends on several factor...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000588
更新日期:2017-11-01 00:00:00
abstract:STUDY DESIGN:This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES:To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) v...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000807
更新日期:2019-06-01 00:00:00
abstract:STUDY DESIGN:A retrospective 1-year cost-utility analysis. OBJECTIVE:To determine the cost-effectiveness of using recombinant human bone morphogenic protein (rhBMP-2) in addition to autograft for 1- and 2-level lumbar fusions. SUMMARY OF BACKGROUND DATA:rhBMP-2 has been studied extensively to identify its benefits, r...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000079
更新日期:2016-02-01 00:00:00
abstract:STUDY DESIGN:This was a narrative review. OBJECTIVE:This study aimed to review the current literature on surgical simulation in orthopedics and its application to spine surgery. SUMMARY OF BACKGROUND DATA:As orthopedic surgery increases in complexity, training becomes more relevant. There have been mandates in the Un...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001070
更新日期:2020-10-09 00:00:00
abstract:STUDY DESIGN:Case series. OBJECTIVE:To evaluate radiographic and clinical outcomes of adults with spinal deformity treated with multilevel anterior column releases (ACR). SUMMARY OF BACKGROUND DATA:Pedicle subtraction osteotomy can be used effectively to correct spinal deformity; however, it is not without complicati...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000377
更新日期:2016-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective Cohort. OBJECTIVE:To determine if an association exists between surgery day and length of stay or hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARYOF BACKGROUND DATA:Length of inpatient stay after orthopedic procedures has been identified as ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000640
更新日期:2018-06-01 00:00:00
abstract:STUDY DESIGN:A retrospective study. OBJECTIVE:To investigate whether proximal junctional kyphosis (PJK) or obvious proximal junctional angle (PJA) changes in the sagittal plane develops following short fusion in children younger than 10 years of age with congenital scoliosis, and to investigate the possible risk facto...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000245
更新日期:2017-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective, blinded analysis of imaging studies. OBJECTIVE:The aim of this study is compare the use of magnetic resonance imaging (MRI) to lateral radiograph using bolster in the evaluation of Scheuermann kyphosis (SK) curve flexibility measurement. SUMMARY AND BACKGROUND DATA:The flexibility of the t...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000346
更新日期:2017-08-01 00:00:00
abstract::The Spine Patient Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with a randomized and observational cohort, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000696
更新日期:2018-11-01 00:00:00
abstract:STUDY DESIGN:A single-center case-referent study. OBJECTIVE:To assess whether the "pedicle screw (PS) fluid sign" on magnetic resonance imaging (MRI) can be used to diagnose deep surgical site infection (SSI) after posterior spinal instrumentation (PSI). SUMMARY OF BACKGROUND DATA:MRI is a useful tool for the early d...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000040
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:All doctors know that P-value<0.05 is "the Graal," but publications require further parameters [odds ratios, confidence interval (CI), etc.] to better analyze scientific data. AIM:The aim of this study was to present P-values, CI, and common effect-sizes (Cohen d, odds ratio, and various coefficients) in a ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000695
更新日期:2018-11-01 00:00:00
abstract:STUDY DESIGN:Large multicenter retrospective cohort study. OBJECTIVE:The objective of this study was to analyze the effect of fusion timing on inpatient outcomes in a nationally representative population with thoracolumbar fracture and concurrent neurological injury. SUMMARY OF BACKGROUND DATA:Among thoracolumbar tra...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001078
更新日期:2020-10-06 00:00:00
abstract:STUDY DESIGN:This was a retrospective analysis of prospectively collected data. OBJECTIVE:To investigate the incidence of thromboembolism in patients who received tranexamic acid (TXA) after lumbar spine fusion and determine the diagnostic value of lower limb duplex sonography as a screening test. SUMMARY OF BACKGROU...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000860
更新日期:2020-03-01 00:00:00
abstract:STUDY DESIGN:This is a retrospective study. OBJECTIVES:(1) To analyze the incidence of second surgery after initial laminoplasty for ossification of the posterior longitudinal ligament (OPLL) due to disease progression, (2) to examine factors associated with poor surgical outcome. SUMMARY OF BACKGROUND DATA:Neurologi...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000747
更新日期:2019-04-01 00:00:00
abstract:STUDY DESIGN:A prospective study with historical controls. OBJECTIVES:To evaluate and compare the safety and effectiveness of recombinant human bone morphogenetic protein-2 (rhBMP-2) with allograft for anterior cervical discectomy and fusion (ACDF) in patients with symptomatic single-level cervical degenerative disk d...
journal_title:Clinical spine surgery
pub_type: 临床试验,杂志文章
doi:10.1097/BSD.0000000000000409
更新日期:2017-11-01 00:00:00
abstract:STUDY DESIGN:An observational prospective cohort study. OBJECTIVE:To investigate the influence of natural history on the recovery of patients with cervical spondylotic myelopathy (CSM) after anterior cervical decompression. SUMMARY OF BACKGROUND DATA:The natural history of CSM has not been clearly elucidated, it rema...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000873
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To provide reasoning and steps for the placement of sacral alar-iliac (S2AI) screws for pelvic arthrodesis to aid osseous lumbosacral fusion. SUMMARY OF BACKGROUND DATA:Studies support lower rates of screw breakage and need for revision surgery or hardware removal for S2AI screws compared with traditional il...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000574
更新日期:2018-11-01 00:00:00
abstract:STUDY DESIGN:A prospective cohort study. OBJECTIVE:The objective of this study was to establish the correlation between radiographic spinopelvic parameters with objective biomechanical measures of function in patients with adult degenerative scoliosis (ADS). SUMMARY OF BACKGROUND DATA:Gait and balance analyses can pr...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000939
更新日期:2020-02-01 00:00:00
abstract:STUDY DESIGN:This is a retrospective comparative review. OBJECTIVE:The objective of this study was to identify the influence of body mass index (BMI) on postsurgical complications and patient reported outcomes measures (PROMs) following lumbar decompression surgery. SUMMARY OF BACKGROUND DATA:Current literature does ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001001
更新日期:2020-12-01 00:00:00
abstract::Microsoft Excel (MS Excel) is a commonly used program for data collection and statistical analysis in biomedical research. However, this program has many limitations, including fewer functions that can be used for analysis and a limited number of total cells compared with dedicated statistical programs. MS Excel canno...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000382
更新日期:2016-06-01 00:00:00
abstract:STUDY DESIGN:Retrospective study using the MarketScan longitudinal database (2006-2010). OBJECTIVE:Compare complication rates between groups of patients undergoing anterior cervical discectomy and fusion (ACDF) procedures performed by surgeons with high versus low mean annual ACDF volume. SUMMARY OF BACKGROUND DATA:O...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000238
更新日期:2017-06-01 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical study of cervical intervertebral distraction. OBJECTIVE:To investigate the forces required for distraction to different heights in an in vitro C5-C6 anterior cervical distraction model, focusing on the influence of the intervertebral disk, posterior longitudinal ligament (PLL), and ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000160
更新日期:2017-06-01 00:00:00
abstract:STUDY DESIGN:This was an innovative concept and a preliminary prospective series. OBJECTIVE:The aim of this study was to present the concept and the technical aspects of patient-specific rods (PSR), and compare preoperative and postoperative sagittal parameters (after PSR implantation), with a special focus on the dif...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000721
更新日期:2019-03-01 00:00:00
abstract:STUDY DESIGN:Cross-sectional study. OBJECTIVE:To determine the correlation between SF-36 (a measure for overall health status in patients) and Oswestry-Disability Index (ODI) or Rolland-Morris Disability Questionnaire (RMDQ) confined to spine according to the type of pain from the spine. SUMMARY OF BACKGROUND DATA:Da...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000438
更新日期:2017-07-01 00:00:00
abstract:STUDY DESIGN:This is a retrospective, self-controlled cohort study, at a single center. OBJECTIVE:The aim of this study was to evaluate the long-term outcome of sexual function after surgical treatment of single-level lumbar disk herniation (LDH). SUMMARY OF BACKGROUND DATA:The impact of surgical treatment on sexual ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000669
更新日期:2018-10-01 00:00:00
abstract::As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000541
更新日期:2018-10-01 00:00:00
abstract:STUDY DESIGN:This was a retrospective comparative study. OBJECTIVE:The main objective of this study was to investigate the effects of epidural anesthesia (EA) versus general anesthesia (GA) in elderly patients undergoing lower lumbar spine fusion surgeries. SUMMARY OF BACKGROUND DATA:Lumbar spine surgery can be perfo...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000708
更新日期:2019-02-01 00:00:00
abstract:STUDY DESIGN:Open-label laboratory investigational study; non-animal surgical simulation. OBJECTIVE:The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. SUMMARY OF BACKGROUND DATA:Incidental durotomy leading to persistent cerebrospinal fluid leak adds...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000169
更新日期:2017-07-01 00:00:00
abstract:STUDY DESIGN:A retrospective case series describing teardrop fracture of the axis. OBJECT:The purpose of the study was to clarify the clinical features, the mechanism of injury, and the potential instability of extension teardrop fractures of the axis, so as to emphasize the importance of recognizing this injury as a ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31828984f9
更新日期:2016-02-01 00:00:00